Clinical evaluation of association between high sensitivity C-reactive protein and stroke
DOI:
https://doi.org/10.18203/2349-3933.ijam20162857Keywords:
GCS score, hs-CRP, Inflammation, StrokeAbstract
Background: Stroke is a leading cause of morbidity and long term disability all over the world. In this scenario, the present hospital based study was undertaken to study the elevation of hsCRP level in cases of ischemic and hemorrhagic, as an inflammatory marker and to assess the association of hsCRP with stroke and its common risk factors like hypertension, diabetes mellitus and dyslipidemia.
Methods: The study was conducted for a period of one year from 2011 to 2012 in 50 cases of stroke from the OPD, emergency and indoor wards of the hospital. 50 controls were also taken for valid comparison. The plasma hsCRP level of all patients was measured using the immunoturbidimetric method. The statistical analysis was done by SPSS v12.0 and EPI-info version 6.0. The baseline comparability was assessed using Pearson’s chi-square/t-test and the comparison between the groups was done by ANOVA.
Results: In the present study out of 50 stroke patients, 35 were of ischemic stroke and 15 were of hemorrhagic stroke. There was a significant (p< 0.05) elevation in both the cases of stroke and the mean hsCRP level was found to be 8.32±6.60 mg/dl. Further, there was no significant association was found between level of hsCRP in stroke case and hypertension, dyslipidemia, diabetes respectively. Furthermore, the poor GCS score was <8 in both the cases of stroke with the high level of hsCRP and the hsCRP level was elevated in non survivors as that of the survivors in both the stroke cases.
Conclusions: Thus, from the study the hs-CRP level was increased in stroke ischemic as well as hemorrhagic, suggesting an inflammatory response in acute stroke.
References
Sweileh WM, Sawalha AF, Al ASM, Zyoud SH, Al JSW. The epidemiology of stroke in northern Palestine: a 1-year, hospital-based study. J Stroke Cerebrovasc Dis. 2008;17:406-11.
Di NM, Papa F. Neuroinflammation an important role in the pathogenic pathways of cerebral ischemia. Nova Science Publishers, Inc., NY, USA.2009.
Wang J, Dore S. Inflammation after intracerebral hemorrhage. J Cereb Blood Flow Metab. 2007;27:894-908.
Pradilla G, Chaichana KL, Hoang S, Huang J, Tamargo RJ. Inflammation and cerebral vasospasm after subarachnoid hemorrhage. Neurosurg Clin N Am. 2010;21:365-79.
Eikelboom JW, Hankey GJ, Baker RI, Mcquillan A, Thom J, Staton J et al. C-reactive protein in ischemic stroke and its etiologic subtypes. J Stroke Cerebrovasc Dis.2003;12:74-81.
Meier EHK, Ridker PM, Rifai N, Price N, Dinges DF, Mullington JM. Absence of diurnal variation of C-reactive protein concentrations in healthy human subjects. Clin Chem. 2001;47:426-30.
Ramadori G, Christ B. Cytokines and the hepatic acute-phase response. Semin Liver Dis. 1999;19:141-55.
Butterweck V, Prinz S, Schwaninger M. The role of interleukin-6 in stress-induced hyperthermia and emotional behaviour in mice. Behav Brain Res. 2003;144:49-56.
Ridker PM, Silvertown JD. Inflammation, C-reactive protein, and atherothrombosis. J Periodontol. 2008;79:1544-51.
Rost NS, Wolf PA, Kase CS, Kelly HM, Silbershatz H, Massaro JM et al. Plasma concentration of C-reactive protein and risk of ischaemic stroke and transient ischaemic attack: the framingham study. Stroke. 2001;32:2575-9.
Bamford J, Sandercock P, Dennis M, Burn J, Warlow C. Classification of natural history of clinical identifiable subtypes of cerebral infarction. Lancet. 1991;337:1521-6.
Kannel, Mcgreen. Diabetes most common risk factor. Arch Inern Med. 1979;54:312-424.
Benson RT, Sacco RL. Stroke prevention: hypertension, diabetes, tobacco and lipids. Neurol Clin. 2000;18:309-19.
Di NM, Papa F, Bocola V. C-reactive protein in ischaemic stroke: an independent prognostic factor. Stroke. 2001;32:917-24.
Arenillas JF, Alvarez SJ, Molina CA. C-reactive protein predicts further ischaemic events in first transient ischemic attack or stroke patients with intracranial large artery occlusive disease. Stroke. 2003;34:2463-8.
Wakugawa Y, Kiyohara Y, Tanizaki Y, Kubo M, Ninomiya T, Hata J. C-reactive protein and risk of first ever ischemic and haemorrhagic stroke in a general Japanese population. Stroke 2006;37:27-32.
Guo Y, Jiang X, Chen S, Zhao HW, Gu KY. C-reactive protein as an important prognostic marker for ischemic stroke. Zhonghua Yu Fang Yi Xue Za Zhi. 2003;37:102-4.
Winbeck K, Poppert H, Etgen T, Conrad B, Sander D. Prognostic relevance of early serial C-reactive protein measurements after first ischemic stroke. Stroke. 2002;33:2459-64.
Elkind MSV, Luna JM, Moon YP, Liu KM, Spitalnik SL, Paik MC et al. High-sensitivity C- reactive protein predicts mortality but not stroke: The Northern Manhattan Study. Neurology. 2009;73:1300-7.
